CREATEing Resilience:
A Guide to Utilizing Community Music Therapy to Serve Military Families
By Ashley Carroll, MT-BC
A Thesis Submitted in Partial Fulfillment of the Requirement for the Master of Arts Degree
Master of Arts in Music Therapy Program in the Departments of Graduate Studies and Music and Theatre Saint Mary-of-the-Woods College Saint Mary-of-the-Woods, Indiana
September 2020
Abstract
Military families in the United States face many challenges, including deployments, relocations, and frequent separations from extended family. This thesis explores the impact these challenges have on resilience and the family bond. A history of music therapy and military populations is introduced, as well as resources currently available to military families. Music therapy is presented as an intervention that can positively impact building resiliency and strengthening the family bond for military families, as evidenced by its success with other populations.
CREATEing Resilience is a program guide created for music therapists interested in providing family-centered, community-based music therapy services to military families. This guide presents themed sessions dedicated to the challenges military families face and utilizes established music therapy techniques such as improvisation, song-writing, and lyric analysis.
Goals addressed include communication skills, emotional expression, increasing self-awareness, stress reduction, building community, and increasing and integrating coping skills. Each session outlines music therapy interventions used, materials needed, sample session schedules, and related psychoeducational material. Possible challenges in implementation and advocacy are also explored.
Keywords: communication, emotional expression, group music therapy, improvisation, military, music therapy, resiliency, family bond, community-based, family-centered, songwriting
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Acknowledgments
First, I need to thank my family for encouraging the decision to return to school. The last two years have been challenging; having your support has meant the world. Next, I would like to thank the women of my cohort: Amy, Alison, Bethany, Brianna, Corinne, Heather, Kazuko,
Kristen, and Laetitia; no words can truly express how much I love you all. Your friendships and support were life-saving, and I cannot imagine going through this program with anyone else.
Finally, I would like to thank the professors and instructors who have helped me understand my clinical work and myself.
To my thesis committee, Tracy Richardson, Barbara Else, and Corinne Richards thank you for your time, support, and guidance throughout this process with all its twists and turns.
Tracy, your support and gentle encouragement to continue forward. Barb, your willingness to be on my committee has genuinely humbled me. I am thankful for your expertise and generosity in sharing your resources and knowledge with me. Corinne, thank you for your honest perspective and helping me write for a broader audience. I would also like to thank Rebecca Vaudreuil for taking time out of her hectic schedule to share her program creation experience and encourage me to create this guide. Elizabeth Schwartz, thank you for both your music therapy expertise and military spouse perspective, Diane Garrison, thank you for helping me to re-evaluate my game- plan. I could not have made it this far without the support of those I have mentioned and everyone I encountered during my time at the Woods. It is truly a special place.
-Ashley
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TABLE OF CONTENTS
ABSTRACT ...... ii
ACKNOWLEDGEMENTS ...... iii
CHAPTERS
I. INTRODUCTION ...... 1
II. REVIEW OF THE LITERATURE ...... 5
The Military Family ...... 5 The Deployment Cycle ...... 9 Family Readiness and Support...... 15 Building Resiliency ...... 16 Family Therapy ...... 17 Family-Centered Music Therapy ...... 18 Music Therapy and Military Populations ...... 19 Building Resiliency through Music ...... 20 Summary ...... 22
III. DEVELOPMENT ...... 23
IV. PROJECT: CREATEing Resilience ...... 25
V. REFLECTION ...... 67
REFERENCES ...... 71
GUIDE APPENDICES
A. Supplies Checklist Form ...... 60
B. Family Profile – Initial Assessment ...... 61
C. Create Your Own Pre-Deployment Plan...... 63
D. Songwriting Protocols ...... 64
E. Effective Family Communication Handout...... 65
F. PCS Resource List ...... 66
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LIST OF FIGURES
1. Combination of Deployment Cycle and Emotional Cycle of Deployment ...... 31
LIST OF TABLES
1. War on Terror Campaigns ...... 1
Guide 1. Program Overview ...... 33
Guide 2. List of Organizations and Agencies for Collaboration ...... 35
Guide 3. Music Interventions: Introductory Session ...... 41
Guide 4. Music Therapy Interventions: Pre-Deployment ...... 44
Guide 5. Music Therapy Interventions: Deployment ...... 48
Guide 6. Music Therapy Interventions: Re-integration ...... 51
Guide 7. Music Therapy Interventions: Relocation ...... 54
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Introduction
After the terror attacks on September 11, 2001, President George W. Bush announced the
Global War on Terrorism. The first campaign, Operation Enduring Freedom (OEF), began in
October of 2001. This campaign, along with Operation Iraqi Freedom (OIF) and Operation New
Dawn (OND), required an increase in deployed troops, resulting in the highest percentage of troop deployment since the Vietnam War (DoD, 2010, 2012, 2015). Not only were more service members deployed without much prior notice, deployment frequency, and length increased
(DoD, 2010; Wenger et al., 2018). Table 1 below outlines the campaigns related to the War on
Terror that began in 2001. Though OIF and OND ended in 2011, and OEF ended in 2014, new campaigns, including Operation Freedom’s Sentinel (OFS), a non-conflict follow-up of OEF, and Operation Inherent Resolve (OIR), began (Torrean, 2020).
Table 1
War on Terror Campaigns (Torreon, 2020).
Campaign Conflict Dates Active Operation Enduring War in Afghanistan October 2001 – December 2014 Freedom (OEF) Operation Iraqi Freedom War in Iraq March 2003- November 2011 (OIF) Operation New Dawn War in Iraq September 2010- December 2011 (OND) Operation Freedom’s War in Afghanistan- January 2015- Present Sentinel (OFS) Follow-on of OEF Operation Inherent Resolve Islamic State in Iraq October 2014-Present (OIR) and Levant (ISIL)
Deployments are not the only hardships military families face. These families also manage frequent relocations, resulting in separation from external support systems and employment struggles for the military spouse (Department of Defense, DoD, 2012). These factors can affect the entire family, including extended family. Military social and psychological
2 research has primarily related to service members with Post Traumatic Stress Disorder (PTSD),
Traumatic Brain Injury (TBI), and other combat-related stress diagnoses, to explore methods of increasing resiliency related to military service. Over the last 15 years, with an increase of deployed service members, the effect deployments had on families became an interest in inquiry
(Wenger et al., 2018).
Spouses reported higher levels of depression, anxiety, and social withdrawal (DoD, 2012;
Kees, et al., 2015). Military children exhibited emotional and behavioral responses, causing issues at school and home (Partida, 2012; Russo & Fallon, 2015; Williamson et al., 2018).
Researchers have begun to explore how to help military families cope with military life struggles, especially deployment challenges (DoD, 2010). As more studies begin to emerge about members of the military family, the gap in research focusing on the family as a whole has become evident (Hollingsworth, 2011; Hicks, et al., 2016). Though limited, more research is coming out on how military families cope with military life and how to produce the best outcomes.
Though research has repeatedly demonstrated that all military family members may be adversely affected by deployments, there is minimal research exploring possible solutions
(Kritikos et al., 2019; Mogil, et al., 2015). Programs exist for spouses such as Homefront Strong
(Kees et al., 2015). However, this program is limited to several cities in Michigan, and the focus of this program centers on individual family members and not necessarily the family unit (Else,
2014). Families OverComing Under Stress (FOCUS) is one program currently in place that focuses on building resiliency within the family unit, using a family systems framework (Mogil et al., 2015).
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Music therapy, as a profession, has roots in serving the military population. During both
World Wars, musicians would volunteer their time to play for injured soldiers returning home.
At the time, physicians and other medical staff recognized music's benefit on morale and soldiers’ psychological states. Furthermore, they recognized the necessity of training the musicians to process through the psychological effects of war with the patients they visited. Isa,
Maud Ilsen lectured on music therapy at Columbia University and founded the National
Association of Music in Hospitals. During World War II, the creation and ongoing study of the
U.S. Army’s Reconditioning Program illustrated that “music is one of the vital elements of a fighting Army” (Bronson quoted in Byers, 2016, p.17). By the end of World War II, 122 veteran hospitals utilized music therapy services (Byers, 2016).
Currently, music therapists are employed by Veteran Affairs (VA) hospitals, along with specialized inpatient units focused primarily on the invisible wounds of war: PTSD, TBI, and other mental health issues related to combat stress (Else, 2014; Vaudreuil, 2016). The author was unable to find current or music therapy programs focused on the entire family. Some programs welcome family members to participate, such as Semper Sound, a program through MusicWorx in San Diego, CA, that offers music therapy and lessons to service members and their families
(Christina Daley, Semper Sound network coordinator, personal communication, 2019). This program does not explicitly address the issues military families face as a unit. A white paper published by the American Music Therapy Association (AMTA) provides the reader with examples of programs running at the time of publication (Else, 2014). This author completed an exploratory search of the programs listed in the paper, and none have current, ongoing programs.
The scarcity of programming is a multifaceted issue, as these programs usually use grant funding and require support from military base leadership. Due to the high turnover of leadership
4 positions, it is challenging to sustain continuous support (personal communication B. Else, April
30, 2020).
The purpose of this project is to provide music therapists with a guide to implement a community-based, family-centered music therapy program focused on strengthening familial bonds and building resilience. Various music therapy interventions are used, such as active music-making, songwriting, and receptive music experiences. This guide will aide music therapists in advocating local military programming directors and leadership about the benefits of integrating music therapy into the services provided to military families. This program guide focuses on the importance of building strong familial and community relationships within the military community. The author also encourages further research on the effects and outcomes of tailored music therapy protocols within the military population and expanding beyond active duty and veteran service members to include their families.
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Review of the Literature
The Military Family
According to the 2017 Department of Defense (DoD) demographic report, there are currently 2.4 million active duty and ready reserve military members. About 40% of military members have children, 85% of those members are married; within this group, 2.2% are dual military, with both parents serving in the military. There are 1.7 million children in military families, most of whom are 11 years old or younger (DoD, 2017). When grouping all military dependents, family members outnumber the full military force.
In addition to dealing with the same struggles all families face, military families encounter issues unique to the military lifestyle, such as frequent relocations, family separation, and deployments. Deployment is defined as “a service member physically located within a combat zone or area of operations or a service member specifically identified by his or her service as ‘directly supporting’ a contingency mission” (Wenger et al., 2018, p. 10).
During OEF/OIF/OND, 2.77 million troops served on more than 5.4 million deployments. The number of military personnel compared with the number of troop-years spent in deployment indicates that many service members deployed multiple times. Those serving in special operation units deployed most frequently, Army soldiers provided the majority of the troops. The peak of US military deployments in Iraq occurred in 2007-2008, followed by a gradual decrease until 2011; deployments in Afghanistan peaked in 2010 and then started to decline (Meadows et al., 2016). A sharp decline of deployed service members began in 2015
(Wenger et al., 2018).
Deployments can last between 10-12 months (DoD, 2017). During deployments, families often have limited communication with their service members, unaware of their location or the
6 dangers they face. According to current casualty reports, 53,241 troops were wounded in action,
5,449 troops were killed in action or died from wounds, and there were 1,579 nonhostile death casualties, since the beginning of the War on Terror in 2001, with over 95% of the casualties occurring between 2001-2014 during OEF/OIF (Blum & DeBruyne, 2020). Nonhostile or nonbattle refers to incidents not directly related to combat or terror attack (Joint Chiefs of Staff,
2020).
When focusing on the effects of deployment, current research centers around the military service member, without considering the effects deployments have on family members, individually, or as a unit. There is no question that deployment is a stressor on the family unit.
However, past research did not focus on the families even though most soldiers were married at the time of their deployments, and half of them had children (Wenger et al., 2018).
When discussing the family's needs during the stages of deployment, information about military family support groups or family readiness programs is the primary focus. Family readiness is the “state of being prepared to effectively navigate the challenges of daily living experienced in the unique context of military service” (Meadows et al., 2016, p. v). In the past, military families received little attention in the literature. However, this is changing as emotional and psychological effects are acknowledged, linking the number of deployments and total time deployed with military family well-being (Chandra et al., 2010 as cited in Wenger et al., 2018).
Parental and Marital Relationships
Allen et al. (2015) conducted a study of over 600 Army families that measured the effectiveness of a program designed to prevent marital stress and divorce by increasing communication skills and other positive interactions between spouses. These results were supported by Blow et al. (2015), who found a higher occurrence of adverse outcomes when
7 spouses used avoidant coping strategies, including a lack of communication. Communication is vital to the success of any relationship. A breakdown in communication, added to the stress and adverse experiences of deployment, can be devastating to the family. A deployment readiness handbook suggests that when writing letters or speaking with the service member, it is crucial to be truthful but tactful. The non-deployed spouse may share joys and frustrations, struggles, and feelings of loneliness, but in a way that reassures the service member, they do not have to worry about what is going on at home (DoD, 2012). However, withholding stressful or depressing information, with the intent to protect the recipient, referred to as protective buffering, can have adverse effects on the individual withholding the information. Being involved in a community where one feels safe to disclose stressors lessens the negative impact, highlighting community building's importance for military families (Joseph & Afifi, 2010).
Kritikos et al. (2019) found that marital satisfaction is linked less to deployment length, more to each individual's mental health. Other factors that played a role were resources available to the couple and interpretation of experiences such as deployments for both service members and spouses. Allen et al. ( 2015) discovered couples who participated in a relationship-based psychoeducational program were significantly less likely to get divorced than the couples in the non-treatment control group, up to two years after the study. A longitudinal study of National
Guard families examined the link between pre-deployment coping skills for both the spouse and the service member and post-deployment mental health and family well-being. There was no positive link between active coping and positive mental health and family well-being outcomes.
However, service members’ and significant others’ avoidant coping pre-deployment negatively affected the post-deployment mental health of both the significant other and the service member, and increased service member parenting stress (Blow et al., 2017). Kees et al. (2015) explored
8 how changing spouses’ personal narratives through support within a psychoeducational group to view their experiences of deployment more positively can benefit not only their wellbeing but the wellbeing of the entire family.
Needs of Military Children and Adolescence
A recurring issue that affects children in military families is relocation. When pairing relocation with the uncertainty of deployments, it can lead to adverse outcomes for children.
Russo and Fallon (2015) surmise that the best education occurs when a student can stay in one school system, which is next to impossible for the military child. There is also a positive link between a child’s ability to cope with deployment and the non-deployed parent or caregiver’s psychological health (DoD, 2010). Children in military families are no better or worse off than other children; they learn to adapt and cope with the military lifestyle. While being military- connected does not ensure adverse effects, the likelihood of negative effects such as depression,
Post-Traumatic Stress Disorder (PTSD), and externalizing behaviors increase when a parent deploys (DoD, 2010; Williamson et al., 2018).
Though the research focuses on older children and adolescents, younger children (ages birth to three years old) are also affected by deployments. There is evidence of infants refusing to eat, appearing listless, throwing tantrums, and appearing irritable or sad (DoD, 2010; Hicks et al.,
2016). Reports show that children aged three to five years old have significantly more frequent behavior problems during deployment than other children. Behavior problems are not only related to the length and frequency of deployments, but other challenges often faced by military families, including frequent moves (James & Countryman, 2012). Proper support and resources are needed to assess each child’s needs during times of high stress and transition. Family-based
9 therapy has shown to be beneficial for military families struggling with behavioral and attachment issues (Hicks et al., 2016; James & Countryman, 2012).
There are special considerations for families with children with special needs (Russo &
Fallon, 2015). J. M. Davis, et al. (2016) surveyed spouses from all military branches on service delivery of interventions for their child(ren) with special needs. All respondents indicated having at least a moderate need regarding access to one or more interventions or therapies for their child. A case study following a young boy with autism illuminates another struggle some military families face: distant, strained relationships with the deployed parent, causing adverse effects with the announcement the service member is coming home (Sullivan, 2015). Hicks,
Lenard, and Brendle (2016) studied how play therapy can increase military familial bonds. Mogil et al. (2015) piloted a virtual therapy program for military families with young children to make parenting services easier to access.
The Deployment Cycle
There are four stages of the deployment cycle: pre-deployment, deployment, post- deployment, and reintegration. Each stage has its own unique set of challenges for the military family, which the Emotional Cycle of Deployment illustrates (CNIC, 2015; Logan, 1987).
Pre-Deployment
Pre-deployment is any time before the next deployment begins. For most military families, this stage is the closest resemblance to civilian life. The service member is home most days, possibly with typical working hours of civilian working parents. During this stage, reservists attend training once a month; otherwise, they are working at their civilian job, keeping their regular schedule at home. However, things change at the end of this phase, as orders for deployment are received, and preparation for separation begins. The service member may be
10 away attending training and briefings related to their upcoming deployment. It is crucial to ensure all personal affairs are in order before the service member leaves, including up to date medical beneficiary information, power of attorney paperwork, living wills, and valid passports for each family member. All essential documents need to be accessible to a responsible party during deployment (DoD, 2012).
The best way to help service members and their children, spouses, and parents prepare for deployment is open communication (DoD, 2012). The family must be aware of the resources and support that are available during deployments. Some other suggestions provided by the DoD
Deployment Guide include building family resiliency by setting personal and family goals, connecting with support systems, maintaining contact with the deployed service member, and knowing where to go for help, if and when it is needed (2012).
Deployments can be incredibly difficult for children. Parents lead by example, openly expressing emotions to show children it is okay to be sad, nervous, or scared. At the same time, reassure children the service member will be careful and has been trained well to do their job.
Leading up to deployment, the service member may want to spend one on one time with each child. As they prepare to leave, some children may like a stuffed animal or doll with a picture of the service member and may like to give their parent a keepsake as well to take with them (DoD,
2012).
Deployment
Deployment refers to when the service member leaves their home and ends when their tour of duty ends. Deployments can last a few weeks to over a year, depending on the campaign.
While families do not face the stress of combat zones and other dangerous situations, deployment can still be a time of stress for spouses and children. Family dynamics shift as
11 spouses undertake the role of being the head of the household, effectively filling a single parent's role while the service member is away. During this time, keeping routines familiar helps children feel more secure and have a sense of normalcy. Carrying on with activities and family traditions also helps children cope with the absence of a parent. Spouses should continue to communicate openly with their children about the feelings they are experiencing. Children should also be encouraged to communicate with the service member, sharing their experiences while their deployed parent is away through letters, phone calls (DoD, 2012). With the technological advances in communication, it is easier than ever for families to stay in touch and see each other using video call platforms.
Given the struggles military children may face, there can also be positive outcomes from a parent’s deployment. Due to the difficulties children may encounter during deployment, they may become more mature, gaining a better understanding of the world and being part of a community at an earlier age than other children their age. Military children can also be more self-sufficient and self-reliant from having responsibilities given to them during and around times of deployment. Family bonds can strengthen among siblings, and the non-deployed parent may make emotional adjustments during times of separation and deployment (DoD, 2012).
Meadows et al. (2016) completed The Deployment Life Study, a 3-year longitudinal study focused on families in which the service member was eligible to deploy within the first twelve months. The service member was not able to be deployed as the baseline. Compared to previous longitudinal studies sampled from the general military population, this unique design allowed for evaluating family functioning at each stage deployment, possibly multiple times. This study looked at various outcomes, including the quality of parental/marital relationships, child and
12 adolescent well-being, the psychological, behavioral, and emotional health of family members; and military outcomes.
Post-Deployment and Reintegration
In the post-deployment stage, the service member has returned home and may have time for some respite before returning to regular duties. Families may take this time to reconnect before returning to everyday life. During the final phase, reintegration, the service member is home. Everyone in the family is readjusting to having the family member back in everyday activities. The service member begins to resume duties at their home command (CNIC, 2015).
Reintegration can be a time of excitement, happiness, and relief. However, it can also be a time of stress, frustration, and anxiety for the entire family. As roles and responsibilities shift, time is needed to acclimate to new roles and readjust family dynamics (DoD, 2015).
Not only have roles and responsibilities changed, but service members and family members have changed. Children have changed physically and developmentally, spouses may be more independent, and service members have changed from experiencing situations that are entirely different from their home environment, and possibly very dangerous. Readjustment to a new environment and new personalities takes time and can cause friction (DOD, 2012). This adjustment period impacts everyone in the family. Spouses must be patient with each other and their children while continuing to encourage open communication. Sandoz et al. (2015) presented the framework of psychological flexibility as a way for families to approach reintegration that fosters understanding among all members of the family.
The Emotional Cycle of Deployment
Due to the uncertainty and change deployment brings, there are various emotions that both service members and their families may experience. Initially, the Emotional Cycle of
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Deployment model was created to describe changes in “Navy wives’ behavior and emotions during deployments of three months or longer” (Logan, 1987, para 3). The cycle now refers to the experience of the entire family (CNIC, 2015).
Stage 1: Anticipation of Departure. Both spouses and service members may become stressed in anticipation of the upcoming deployment. Service members may feel added stress from long days in preparation for deployment, which may carry over into home life. Spouses may be frustrated, stressed, or even in denial of upcoming separation. These feelings may also fluctuate between the denial and feelings of anticipatory sadness and stress they will feel while their spouse is away (DoD, 2012).
Stage 2: Detachment and Withdrawal. This phase usually occurs within the last week before the scheduled deployment date. The service member focuses on ensuring all responsibilities are taken care of before deployment, possibly spending more time with their unit, creating emotional distance between themselves and their spouse. Spouses may also be creating emotional distance, sometimes unconsciously, to protect themselves from emotional pain(DoD,
2012).
Stage 3: Emotional Disorganization. This stage occurs in the days and weeks following the service member's departure. The non-deployed spouse is creating new routines in order to manage all the household responsibilities. During this time, spouses may become depressed or feel overwhelmed by new responsibilities. After a while, these feelings subside as the family settles into their new routine. A reliable support system that helps with responsibilities within the home can lessen the level of emotional distress and disorganization experienced during deployment (DoD, 2012).
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Stage 4: Recovery and Stabilization. During this stage, spouses settle into new routines and may have a sense of confidence in their ability to run the household and to cope with the deployment (DoD, 2012). The added responsibility of being a single parent can be stressful and isolating, spouses may find themselves feeling vulnerable, falling ill more frequently, and some may continue to feel depressed and anxious (Logan, 1987). Overall, this is the stage where many spouses discover their strength and independence, and communication with the service member has occurred, reinforcing the spouse’s inner strength (Hochlan, 2017).
Stage 5: Anticipation of Return. Families are excited about their service members to come home. This excitement may also come with some questions or concerns. With newfound independence and confidence, there may be some issues relinquishing duties back to the service member. It may help to discuss expectations before deployment so that everyone can be on the same page (DoD, 2012).
Stage 6: Return adjustment and Renegotiation. During this phase, service members and their families adjust to the new normal, managing expectations and redefining roles. There may be some tension as the service member and spouse redistribute household responsibilities.
In this stage, both spouses need to maintain open communication regarding expectations. This period is also the time to be on the lookout for symptoms of combat stress and trauma; both service members and spouses should be familiar with signs and have resources regarding whom to contact if any concerns arise (DoD, 2012).
Stage 7: Reintegration and Stabilization. Over time, relationships stabilize as the family settles into new routines and roles. Relocation and any combat-related stress can disrupt this stage. Families can work together toward stabilization, even given these added stressors
(DoD, 2012).
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Family Readiness and Support
Deployment is an expected part of military life. However, this does not mean that families do not have to prepare for an upcoming deployment. Having a plan and open communication among family members will reduce stress and increase resiliency (CNIC, 2015).
From the start of Operation Iraqi Freedom (OIF) and until the end of 2015, deployment rates were increased. With this increase, the toll deployments take on service members and their families became apparent (Wenger et al., 2018). Researchers began to question how deployments affected the wellbeing of both service members and families.
Family Readiness Groups, initially referred to as ‘coffee groups,’ have been around since the Revolutionary War to support families of soldiers who were in combat (Alfonso & Wood,
2018). However, it was not until the 1970s, after a Family Awareness Conference brought attention to the needs of military families, that the first official Fleet and Family Services
Program opened in 1979 in Norfolk, VA (CNIC, n.d.). Family readiness programs have become a pillar of support, with service delivery sites located across the globe, on military installations, and in the community, offering a wide array of programs (Alfonso & Wood, 2018). Programs offered include free counseling for the entire family, financial literacy, parenting, and relationship courses; delivered in person, through webinars, webpages, and social media (CNIC, n.d.). Each branch has resource centers, with branch and command-specific information.
Military One Source is a website with an extensive catalog of resources and information regarding military life, including webinars, links to information for local resources, research, and information on a range of topics including education and employment, family and relationships, military life cycle, health and wellness, and more. Military family members can also call Military
One Source twenty-four hours a day, seven days a week, 365 days a year, for more personalized
16 assistance (Military One Source, 2019). While there are tools and information regarding how to help families cope with the stress of deployment and the adjustment of reintegration, families may not always be able to access a group or have the opportunity to practice or learn these skills in an educational environment.
Building Resiliency
Resilience is the “ability to withstand and rebound from disruptive life challenges”
(Walsh, 2003, p.1). Disruptive life challenges may refer to relocations, lack of external support systems, and deployments for military families. Military resilience focuses on the service member and refers to the “capacity to overcome the negative effects of setbacks and the associated stress on military performance and combat effectiveness” (Nindl et al., 2018, p. 1116).
Family resilience relies on the entire familial unit's outcome, not the individuals within
(Patterson, 2002). The family’s belief and confidence in finding solutions and resources to manage their current struggle are necessary to have positive outcomes. Patterson (2002) describes these building blocks of resiliency as protective processes and core functions of the family, including effective communication, adaptation, a nurturing and safe environment, a sense of belonging, and economic function. Walsh (2003) defines nine key processes in family resilience: making meaning of adversity, positive outlook, transcendence and spirituality, flexibility, connectedness, social and economic resources, clear communication, emotional expression, and collaborative problem-solving.
Viewing resilience as a process, instead of a trait, allows for the understanding that families may not be resilient at all times under every circumstance (Patterson, 2002). Music- based interventions are also process-focused; participants can explore the fluidity and flexibility of their emotions and feelings at the moment with the support of a board-certified music
17 therapist. Families OverComing Under Stress or FOCUS is a military and trauma-informed preventative intervention program to support parents using psychoeducational tools. It provides parents with information on child development, deployment, and integration, constructing a family narrative, enhancing parenting strategies, and the parent-child relationship. This program has been adapted for families with young children and can be administered in person and through a telehealth program (Mogil et al., 2015). Music therapists working in other populations address similar goals to those in the FOCUS program, such as enhancing emotional regulation, communication, goal-setting, and problem-solving (AMTA, n.d.). As discussed earlier, the building blocks of resilience are communication, emotional expression, and coping strategy resources.
Family Therapy
Family therapy differs from individual therapy in that it addresses challenges faced by the family unit instead of individual family members. Hollingsworth (2011) proposed the
Community Family Therapy (CFT) framework to work with military families. This framework not only focuses on the individual family unit but also integrates the broader military community as part of the more extensive system to which military families belong. The goal of
CFT is to promote family resilience within the family and facilitate connections within their community. Hicks et al. (2016) explored the benefits of play therapy with military families, referencing literature illustrating the effectiveness of filial therapy in improving children’s emotional, psychological, physical attachment and relationship issues often experienced in military families.
Filial therapy also includes the parents in the process, which in turn strengthens the parent-child bond. Better relationships and open communication create trust within the family
18 unit and strengthen bonds (Walsh, 2003). In many military-related materials, the term
‘resilience’ is used frequently. When referring to service members, the term is used to describe resiliency against PTSD and other combat-related trauma and learning to cope with the realities of combat. For families, ‘resilience’ or ‘resiliency’ refers to the ability to cope with deployments and other stressors of military life (DoD, 2012).
Patterson (2002) explores how family resilience is related to family stress and discusses the Family Adjustment and Adaptation Response (FAAR) Model. The FAAR Model views the responses of the family unit as unique from the responses of individuals. When demands on the family outweigh the family’s capabilities, the family must adjust and adapt to restore balance, which can have a positive or negative result. Patterson (2002) states that family bonds can be either strengthened or shattered by crisis or chronic stressors. How families approach crises or stressors they are experiencing has a significant effect on how it affects the family unit. Open communication and effective coping skills can be the difference between whether familial bonds are strengthened or strained during times of stress.
Family-Centered Music Therapy
“Family-centered care is associated with improved parenting, positive child development and behavior, family satisfaction, self-efficacy, and well-being” (Nemesh, 2017, p. 168).
Currently, there is no family-centered music therapy model explicitly designed for military families, nor has research focused on utilizing a family-centered music therapy framework in the military setting; past research centers around parent-child dyads or families with children with specific diagnoses or special needs (Nemesh, 2017). Family music therapy has shown positive results in other populations such as children with autism, in the neonatal intensive care unit, and
19 hospitalized children (Avers, et al., 2007; Haslebeck & Hugoson, 2017; Jacobson & Thompson,
2018; Roa & Ettenberger, 2018, Thompson, 2012 ).
Music Therapy and Military Populations
The origins of music therapy began with musicians performing for soldiers returning from World War I. Musicians would play in hospitals, at the bedside of wounded soldiers. After physicians and other hospital staff observed the positive outcomes and patients’ responses to music, staff determined that musicians coming into the hospital required more specific training to serve the patients better. Margaret Anderton taught the first collegiate music therapy course in
1919. She provided music therapy services to Canadian soldiers suffering from mental and physical disabilities during World War I. During World War II, volunteers played music to boost morale and support the physical and emotional rehabilitation of wounded soldiers (W. B. Davis et al., 1999). With this early interest and research into music's benefits with military populations, music therapy eventually became recognized as a necessary treatment for wounded soldiers
(Bronson et al., 2018).
Currently, music therapists working with the military population are either employed by or contracted with the Department of Veteran Affairs (VA), the DoD, or serve military families in the community (Else, 2014). Music therapists may work in VA hospitals, on military installations, community agencies, or private practice. Music therapists have become providers as part of the Exceptional Family Member Program (EFMP) in several states, providing music therapy services to children with special needs (J. M. Davis, et al., 2016; Else, 2014). Even more rare is programming for the whole family. However, family members may reap the secondary benefits of the service member’s involvement in music therapy services, access to this service for
20 themselves is limited. The author could not find evidence of a currently running family-focused music therapy program after several searches.
Building Resiliency Through Music
Music As a Coping Skill
Music therapy has a long history intertwined with the military community. Through music, military families can promote adjustment to a “new normal” leading up to deployment.
After the reintegration phase, it provides opportunities for nonverbal communication between family members an encourages self-expression.
Active Music-Making
In the two programs for family members briefly described in the American Music
Therapy Association’s (AMTA) white paper on military populations, active music-making allowed participants to express themselves, release feelings of frustration and anger, and feel a sense of accomplishment (Else, 2014). In other music therapy settings, active music-making can provide opportunities for families to work together as a team, able to have a conversation without words while retaining the ability to convey emotions. Active music-making, including playing instruments, can give the family a sense of control and choice they may not experience in a military lifestyle. Families demonstrate their strengths and areas of needs through improvisation, in a prompt, clear fashion, determinable by the music therapist (Nemesh, 2017).
Songwriting. Songwriting can be done individually or as a family, creating music that represents familial relationships and dynamics. Family members can write about their feelings, giving each family member a voice. Songwriting provides participants a creative way to address issues and express emotions projected through their lyrics. This process may also provide emotional release and catharsis. Baker (2017) outlines three models in a protocol for
21 songwriting: insight, narrative, and psychoeducational. For this study, each family may choose either insight or narrative songwriting. Insight songwriting encourages exploration of feelings and behaviors, provides insight, and reframes thoughts, feelings, and behaviors viewed as
“barriers to coping and wellbeing. Narrative songwriting uses storytelling to reconstruct the family narrative, challenging participants to “view issues from other perspectives and reframe negative thinking” (Baker, 2017, p. 22).
Songwriting within the entire group will use Baker’s (2017) protocol of psychoeducational songwriting, incorporating elements of the groups shared experience, in the case of this study, military family life to create alternate ways of thinking and behaviors, working together with the group to develop strategies that
Receptive Music Experiences
Bruscia’s definition of receptive music experience is:
the client listens to music and responds to the experience, silently, verbally, or another
modality. The music used may be live or recorded…in various styles….The listening
experience may be focused on physical, emotional, intellectual, aesthetic, or spiritual
aspects of the music and the client’s responses are designed according to the therapeutic
purpose of the experience (Grocke & Wigram, 2007 p. 16).
A music therapist utilizing receptive music experiences in group settings with families must consider all the chronological and developmental ages. The goal of receptive experience can include relaxation, listening to other family members' songs, or facilitating a lyric analysis to encourage reflection and discussion.
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Summary
Current research examines the negative implications and risks military families encounter during the different stages of deployment. The emotional cycle of deployment indicates what service members, spouses, and children may be experiencing. It is also essential to be mindful of children’s developmental age, as this will also affect coping and emotional responses to various phases of deployment. Resources currently available to military families are accessible in various ways, both in-person and virtually, though access and options vary by location and service branch (DoD, 2012).
Family systems theories suggest that families who communicate and form closer bonds show higher resilience (Patterson, 2002; Walsh, 2003). Can these connections be fostered among military families, especially while they are separated, so when service members return, the transition back to “life as normal” may be smoother? Music therapy can address goals and provide family bonding opportunities through shared music-based experiences, providing a space for family members to express their feelings. The therapist provides support to all participants and encourages group cohesion and community building.
The ability to nonverbally communicate during and through music is unique. It creates an environment of safety for all family members to express emotions they may not otherwise feel comfortable expressing verbally. Military families face many stressors. There is a lack of programs that address the relational issues military families face as a unit. The military program focused on the family unit that integrates creative arts therapies, such as music therapy, are virtually non-existent. Therefore, this project aims to create a program focused on building and strengthening familial bonds, building resiliency, and creating community through shared creative and musical expression.
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Development
Design
This clinical project consists of a program proposal to be used by music therapists to provide programming to military families. The focus is on building resiliency, strengthening family and community bonds, and relationship building through music therapy interventions and psychoeducation. This program guide includes session plans, specific music therapy interventions, psychoeducational resources, and possible implementation challenges. The proposed program is community-based and family-focused. It utilizes music therapy interventions such as songwriting, active listening, music and imagery, and group improvisation.
The psychoeducational piece of the program's focus is the unique challenges military families experience, including the stages of deployment and relocation. The goals and objectives of the outlined music therapy interventions include providing social support, improving coping skills, increasing communication, emotional expression, and building trust.
Steps in the Development of the Clinical Project
The author developed the guide to provide a community-based, family-focused music therapy program specifically for military families. First, the author continued to review the literature to a) understand military family needs; b) research established programs, therapies, and the effectiveness of current services available to address coping skills, family preparedness, bonding, resiliency, expression, and provide social support to military families; and, c) explore current music therapy services within the military community. Next, the author created session plans and music therapy interventions to address goals, as mentioned above. Each chapter compiles and organizes psychoeducational material and resources related to each session's thematic focus (i.e., stages of deployment, relocation) by subtopic. Other sections of the guide
24 include advocacy and funding resources. The program proposal is organized in the following sections:
I: Overview of Challenges Facing Military Families: How Music Therapy Can Help
II: Implementation and Potential Obstacles
III: Pre-Deployment: Emotionally Preparing for Separation
IV: Deployment: How to Stay Connected During Separation
V: Re-Integration: New Connections, New Roles
VI: Relocation: How to Cope with Frequent Moves
Appendices
Evaluation
The manual's feasibility was evaluated by two music therapists who currently work with military populations and a music therapist who is also a military spouse. They provided feedback as to the practicality and usefulness of the guide. Going forward, the author will use this guide as the basis of a feasibility study and pilot program to evaluate its effectiveness as a program guide and resource in creating either a community-based or military-affiliated music therapy program for military families. At the end of the pilot study, participants will be asked to provide feedback.
The next step in evaluation would include other music therapists initiating the same program and providing feedback to the author from their participants.
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CREATEing Resilience:
A Guide to Create a Community-Based Music Therapy Program for Military Families
By Ashley Carroll, MT-BC
26
CREATEing Resilience:
A Guide for Creating a Music Therapy Program for Military Families
Author’s Note ...... 27
Introduction ...... 30
Creating a Program and Choosing Session Topics ...... 32
Considerations for Implementation and Possible Challenges ...... 37
Session One: Welcome and Introductions ...... 40
Session Two: Pre-Deployment ...... 42
Session Three: Deployment ...... 46
Session Four: Reintegration ...... 49
Session Five: Relocation ...... 52
Session Six: Bringing it All Together ...... 56
References ...... 58
Appendices
A. Supplies Checklist Form ...... 60
B. Family Profile – Initial Assessment ...... 61
C. Create Your Own Pre-Deployment Plan ...... 63
D. Songwriting Protocols ...... 64
E. Effective Family Communication Handout ...... 65
F. PCS Resource List ...... 66
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Author’s Note
In 2014, my husband changed careers completely, leaving his profession as a teacher, to enlist in the Navy. At the time, I was working full-time as a hospice music therapist. After being told where our first move as a military family was taking us, I found out I was pregnant with our first child. As we arrived at our new home in a new city, Norfolk, Virginia, I was thrust into a culture utterly unfamiliar to me. Military culture encompasses every facet of life for the military family, not only for service members but also for their spouses and children. As I transferred from the role of professional to stay at home parent, feeling lonely and unsure of how to spend my days with a new baby, I sought other mothers with young children. Living in military housing had a built-in community of other women living parallel lives to my own.
As I became more entrenched in military life, I began to contemplate my professional future. I joined the Virginia Music Therapy Association in an attempt to stay connected to my professional self. As I began looking for professional opportunities, my husband informed me he would be leaving for training for six months, after which we would be moving, and I learned I was pregnant with my second child. This news stopped my professional goals in their tracks. It was the first time that I felt it was not entirely my choice to stay home. The challenges of military life affected the decisions I made regarding seeking employment. In 2017, we moved and welcomed our second child. After settling into our new home and routine as a family of four,
I began to seek out employment opportunities. However, there were no music therapy positions available. I connected with the other music therapist in private practice and began building a business plan. I discovered my first roadblock to obtaining clients was dependable and affordable childcare, which became more insurmountable after the devastation of our community from
Hurricane Michael in 2018.
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During this time, I also decided to go back to complete my Master’s in Music Therapy after not actively practicing music therapy since 2015. Now, it is 2020. We are in the midst of another crisis out of our control. This time, the whole world is affected by a pandemic caused by the COVID-19 virus. Initially, my thesis was to be a qualitative study, exploring the impact of a community-based, family-centered music therapy program for military families. However, due to the limitations and governmental orders banning social gatherings, my study was halted. Without a foreseeable change in circumstances allowing me to complete the study, I decided to change my focus to a project I could complete without participants. I decided to assemble a program proposal that would outline how to utilize music therapy to serve military families. I plan to connect agencies who serve military families to include music therapy programming into their offerings with this proposal. I hope that other music therapists will be able to do the same.
During my graduate studies, I began to research an area of need where music therapy could help. I discovered music therapists nationwide are serving active duty and veteran service members through various organizations and agencies, including the VA health system, Creative
Forces (a federally supported program under the National Endowment for the Arts), and community music therapy programs. As emerging research is published, national attention grows regarding music therapy's benefits in treating PTSD, TBI, and other combat-related injuries.
However, after speaking with music therapists who work in these settings, it became clear that these programs' focus is only the military service member. The family members are considered secondary beneficiaries with some, but very limited, inclusion in treatment sessions. I decided to focus on military families, a community that is currently under-represented in music therapy literature. My experience as both a music therapist and a military spouse merged into a desire to
29 create a program for military families to come together in music to strengthen their bonds and build resiliency to face military life challenges together.
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Introduction
The purpose of this guide is to illustrate how instituting community-based music therapy programming tailored for military families may provide an essential service to the overarching military community. This guide is designed for use by board-certified music therapists. It can assist in efforts to advocate for program implementation in their area and serve as an example to agencies who serve military families how a music therapy program can benefit military families, including examples of sessions. To the author’s knowledge, there are no on-going music therapy- specific programming that solely serves military families. The author reviewed information on workshops and other short-term projects that have served this population; however, the goal is to institute ongoing, sustainable programming that is an integral part of the support services provided to families throughout the United States Armed Forces and affiliated networks.
Overview of Challenges Facing Military Families
Military families encounter challenges that civilian families may not fully comprehend, such as the uncertainty and inability to control when a spouse may need to leave the family, either for training or deployment, or when the entire family must relocate. Military families relocate three times more frequently than their civilian counterparts (J. M. Davis et al., 2016).
Each new relocation comes with new challenges for family members. Non-military spouses in the workforce may be looking for employment and possibly need to satisfy licensure or regulatory requirements in a new state. Children need to adjust to new schools. Given the variation in quality across education systems across the country, military children change school districts up to nine times between Kindergarten and 12th grade. Furthermore, access to resources necessary for family members with special needs varies from state to state (The Ohio State
University Project Team, 2011).
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In a 2017 survey of active-duty military spouses, 24 percent of respondents reported being unemployed, with 34 percent reporting not looking for work for various reasons, such as lack of affordable childcare, preparing or recovering from a recent move, or service member deployment (Dorvil). Ninety-eight percent of military families with a child with special needs have at least one area of need not being met (J. M. Davis et al., 2016). Deployments provide unique challenges for military families. Figure 1 illustrates the socio-emotional responses related to each stage of deployment. Military families face many challenges, from frequent relocations, deployments of one or both parental units, separation from physical support systems. Due to these and other daily challenges military families experience, they need support.
Figure 1
Combination of Deployment Cycle and Emotional Cycle of Deployment
Pre- Deployment Deployment Emotional Anticipation of Disorganization Departure Recovery and Detachment and Stabilization Withdrawal
Reintegration Post- Return Deployment Adjustment and Renegotiation Anticipation of Return Reintigration and Stabilization
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How Can Music Therapy Help?
Since World War I, music has been used with the military population, which is considered the genesis of music therapy as a profession in the United States. Over the last century, music therapy has grown into a profession that serves clients of all ages, cultures, abilities, and diagnoses. Treatment facilities for veterans and active-duty military members living with Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), other combat-related injuries and stress disorders provide music therapy services. Within these programs and institutions, the treatment is focused on individual needs, centered around the pathology of a diagnosis.
Music therapy can uniquely serve the military community to bring families together in solidarity, to share their experiences, and receive support. The community-based model encourages participants to not only make connections within their own families, but with other families, all while making music together as part of a positive, and typically, fun interactive experience. Vaudreuil et al. (2020) explore how music therapy supports and builds on the camaraderie unique to service members. In the military, camaraderie is vitally connected to well- being. This sense of cohesion can provide a buffer to service members from developing PTSD and depression. This proposal, created within a community-based approach, combines music therapy interventions and psychoeducational components to provide military families with resources and tools to use in their everyday lives.
Creating A Program and Choosing Session Topics
The program outlined in this guide is an example of a six-session program focused on building resiliency and strengthening family and community bonds. The therapist can assess participants' musical backgrounds and individuals' and families' needs during the screening
33 process. Guide Table 1 is a quick reference outlining the layout of the entire program. The first week is an introductory session followed by three weeks of sessions organized around the deployment stages, then a week covering relocation, with the final week serving as a culmination of the groups’ time together.
Guide Table 1
Program Overview
Title/Topics Overview Session One Welcome and Introductions: • Introductions Community Building • Discuss Goals • Group Rules/Confidentiality • Review planned music interventions (for possible triggers) Session Two Pre-Deployment: Emotionally • Emotional Exploration Improvisation Preparing for Separation • Family readiness (Deployment Plan) • Open Communication Mindfulness
Session Three Deployment: How to Stay • Improvisation: Connection Connected During Separation • Discussion: “How to Stay Connected” • Songwriting
Session Four Post-Deployment/Re-integration: • Discussion: Effective Communication New Connections, New Roles • Effective Communication Music Experience • Songwriting continued from session three
Session Five Relocation: Coping with Frequent • Mindfulness and Improvisation Moves • Lyric Analysis • Songwriting (continued) • Homework: Lyric Analysis/Song Share Session Six Bringing It All Together • Song sharing • Discussion • Reflection • Closing/Termination
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The author selected the stages of deployment and relocation to anchor the session topics because they impact all military families. Specific timelines and the number of sessions per topic can be modified and tailored when creating a program, depending on the families’ needs, the proposal scope, and agreement with agencies or organizations related to music therapy services.
Sessions outlined in this guide suggest a timeline of 90 minutes; however, this is flexible based on the individual music therapist's goals, specific family needs, and the therapist’s military community connection parameters.
Getting Started
Music therapists who may find this guide helpful may already be working with military populations and have an interest in expanding current services to include family members. These individuals may already have an agency they can collaborate with to provide a family-centered program. If the reader does not currently have military community connections, do not fret!
Refer to Guide Table 2 on the following page for community organizations to connect with that may be able to assist with getting a program started.
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Guide Table 2
List of Military Organizations and Agencies for Collaboration
Organization/ Description Website Locations Agency Americans for the The mission of AFTA is to https://www.americansf Programs are Arts (AFTA) “build recognition and orthearts.org/ located all over support for the the United extraordinary and dynamic States, with value of the arts and to lead, some serve, and advance the international diverse networks of programs. organizations and Headquarters individuals who cultivate located in the arts in America.” Washington, D.C
Creative Forces: An arm of the National www.arts.gov/national- Various NEA Military Endowment for the Arts. initiatives/creative- locations Healing Arts Helps military members and forces including: Network – their families find creative AK, CA, CO, Community arts opportunities in their FL, NC, TX, Network community as they VA, WA, and transition from clinical Washington, treatment to community D.C. programming. Community Connection projects in collaboration with Creative Forces sites across the country. Family Support These centers are located on To find a local Center, Various Centers or near military bases and go to locations provide counseling, https://installations.milit psychoeducational aryonesource.mil Centers programming, support searchable by zip groups, and classes and Search “Program or code workshops on a variety of Service” and select topics. “Family Center.” Families Over Resilience training https://focusproject.org/ Designated Coming Under grounded in research on military Stress (FOCUS) family resilience and installations and prevention programs, online adapted especially for military families.
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National Military A national organization with www.militaryfamily.org Programs are in Family the needs of military various Association families in mind. Operation locations. Purple programs include retreats for military families. Wounded Warrior Serves veterans and service woundedwarriorproject. Nationwide Project members who incurred a org physical or mental injury, illness, or wound while serving in the military on or after September 11, 2001.
Once a program is approved, the next step is recruiting families to participate. Something to keep in mind during this process is the military hierarchy. It may be impossible to avoid altogether having both lower and higher-ranking personnel in the same group. It is vital to be aware of the hierarchical dynamics that may occur and the effect the hierarchy can have on interactions, especially among the service members. Since one of the goals is building a community outside of the session, the music therapist may decide to recruit certain ranks for a particular group. A simple screening tool (Appendix B) can solve this problem and include specific rank requirements (ex. E1-E6, for lower-ranked service members) on recruitment materials.
During recruitment, have a predetermined maximum number of participants. If providing the sessions independently, consider limiting the group to three to four families. If collaborating with other therapists or facilitators, it may be feasible to have a larger group, review timelines, and session schedules to allow all participants to engage in discussions, music therapy experiences, and processing. Other considerations for recruitment include ages of children and the need to adapt interventions in this guide based on the ages of each family's children.
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Room Setup
Being familiar with the location where the group will meet is crucial. The therapist or group facilitator must have a plan for the session time and physical space structure and organization. For example, decide how and where to situate participants during the sessions. The author suggests placing chairs in a large circle with instruments located in the center. If the center is too distracting, have the instruments located at an equally accessible location within the room (i.e., a table outside the circle). It is also essential to be prepared with all the tools and supplies one needs as the group facilitator. The music therapist will need access to a speaker/music playing device during multiple sessions and must plan accordingly and set themselves up to allow the facilitator to control any electronic devices and access an electrical outlet if needed. Other considerations for participant safety and comfort include ensuring not to block exits with chairs and accommodate participants' preferences for seating (i.e., facing exits).
Supplies Needed
Preparing for groups is exciting and can be nerve-wracking. Being prepared with all the supplies needed is vital to a smooth-running group. Refer to Appendix A for a general list of supplies and resources needed for each session. The session-specific supplies and resources are also listed within the individual session plans through the guide.
Considerations for Implementation and Possible Challenges
If you have read this guide, you already have an interest in serving the military community. Familiarize yourself with military culture, as you would learn about any other subculture. Read literature, speak to community members, acknowledge what you do and do not know about military families' lives. Although it may be seen as unhealthy in the civilian world, never to show emotion or remain stoic, this is vital and necessary in military culture, especially
38 among the service members. You may be the first music therapist any of these individuals have encountered; therefore, education and advocacy may be necessary for the first session.
Service members in the group could be dealing with PTSD; this information is a part of the intake form, though no one must disclose any diagnoses. It is essential to inform participants of potential contraindications of music therapy experiences, such as drumming. Have this discussion during the introductory session and allow for individuals to communicate any concerns privately. If necessary, seek supervision before implementing interventions that may trigger clients with PTSD or other combat-related stress disorders.
Another consideration is the age of participants. Will there be requirements put in place for the ages of the children? The interventions in this guide were created for families with school-aged and adolescent children. If families interested in this type of program have younger children, adapt interventions to reflect their developmental level. If there is a significant age gap among the children in the group, the guide can be used with adaptations to incorporate developmentally appropriate experiences for participating families.
Another challenge is time; the topics covered in this program are complicated, layered, and could have many sessions dedicated to each one. The sample outlines show how compact each session can be. This guide provides the reader with ideas of engaging military families in conversations and advocating for music therapy with this population. If an intervention is not working, use clinical skills and training as a music therapist to adapt to fit the group's needs. If working with an ongoing program, it may be possible to devote more time to interventions and continue to process topics over several weeks.
Location is important. Are services being provided in a community setting, at a military- related organization site, or on a military base? The answer to this question may create other
39 obstacles. If providing services on a military base, know the proper chain of command. Before starting any sessions, you may need to meet with the Commanding Officer (CO) of the base to introduce yourself. Remember to keep the meeting brief unless the CO is the one extending the meeting time. Ensure you know the procedures and time necessary for gaining base access and what you are required to bring each time you visit.
Working with military families as a unit is relatively new in the music therapy community. Approach the work humbly, embrace the experience, and learn from it. Use this guide to inspire your clinical knowledge to create programming for these families. Know the community in which you want to work and tailor the program to fit them.
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Session One:
Welcome and Introductions: Community Building
At the start of the first session, give each family a Family Profile (Appendix B) to complete. The music therapist uses this to guide song choices for discussion, lyric analysis, and song-writing experiences throughout the program. If possible, one may consider disseminating these profiles before the first session and asking participants to bring completed profiles to the first session. In this session, the music interventions are “ice breakers,” introductory, and provide a foundation for group cohesion and trust.
Materials Needed
One copy per family of Family Profile (Appendix B) (only needed if not filled out during screening for each family).
Copies of Songwriting Fill-in-the-Blank Activity (music therapist can use the example provided on the next page or one of their own)
Sample Schedule
00:00- 00:05 Welcome – Introduction to Music Therapist/other facilitators
00:05- 00:15 Complete Family Profiles
00:15- 00:25 Rhythm Name Game
00:25-:35 Discussion: Creating group rules, explain confidentiality rules, an overview of the program, answer questions.
00:35- 00:45 Group Percussion
00:45- 01:00 – Songwriting in Family Units
01:00- 1:15- Song Share and Discussion
1:15- 1:30- Wrap-Up
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Guide Table 3
Music Interventions: Introductory Session
Name of Intervention Description Goal/Objective Rhythm Name Game Each group member • Playing alone in a group in a introduces themselves and fun interactive way plays the rhythm of their • Group introductions name on a drum or rhythm • Group listening instrument. Group members repeat rhythm back. Group Percussion Group members pick an • Emotional expression Instrument Playing instrument that they feel • active listening drawn to, the facilitator will • group cohesion provide a steady beat and ask members to join in when they feel comfortable. Fill in the Blank Song Give each family a lyric sheet • Introduction to simple parody Parody for fill- in the blank parody. song-writing technique Each family will work • Simple intervention that all together to complete the family members can equally songs. Group together to contribute share songs. • Family communication and teamwork.
Fill-in-the-Blank Songwriting Sample
To the tune of “Sweet Home Alabama” King, Rossington, & Van Zant, 1974)
Big _____ keep on ______Carry me home to see my kin Singin’ songs about ______I miss ______once again And I think ______, yes
Well I heard ______sing about ______Well I heard ______Well I hope ______will remember A ______don’t need ______
Sweet Home ______Where ______are ______Sweet Home ______I’m coming home to you Session Two
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Pre-Deployment: Emotionally Preparing for Separation
Pre-deployment is any time before the next deployment. This session will have two elements. First, the psychoeducational component of learning about the emotional effects of pre- deployment on all family members and second, learning to use music in times of stress and as a way to express oneself. In this stage, families can find routine in the daily schedule, with little disruptions; however, this routine changes as military members begin to prepare for deployment within the last month before deployment. It is at this point that emotions may begin to run high in military households. A pre-deployment readiness checklist can be helpful for families to navigate and prepare for their next deployment. The psychoeducational activity involves each family completing a Pre-Deployment Plan (Appendix C), a tailor-made plan for their family’s specific needs, which they can use as a reference in the future.
Music therapy interventions in this session focus on emotional self-awareness and empathy for others. Each participant must have an opportunity to “solo” and feel supported by their family and the group. Use clinical judgment as to how to proceed if time is limited. The overall goal here is for everyone to feel heard and supported. The goal is for the follow-up discussion to be organic and flow naturally as individuals share their experiences. If the group needs some assistance to start the discussion, the reader can use prompts and questions provided below to get the discussion started. These questions are only suggestions. Use clinical judgment when deciding which prompts to use, if any.
Discussion Prompts and Questions
• Have individuals share if and how they felt supported.
• Ask individuals to guess the emotions others were portraying in the music.
• What aspects of the music helped them come to that conclusion.
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• How was it being the “soloist”? the supporter?
• What was your experience in each role?
• Did you feel more comfortable in one role?
Materials Needed
Copies of “Create Your Own Pre-Deployment Plan” (Appendix C) for each family
Copies of sample checklists (available on Military.com, Military One Source, and other
resources) to use as a guide.
Sample Session Timeline
00:00-00:10 Welcome/Re-Cap of Week One
00:10- 00:20 –Exploring Emotions Through Music Making (Part One)
00:20 - 00:35 Pre-Deployment Discussion/Families Complete “Create Your Own Pre-
Deployment Plan” (Appendix C)
00:35- 00:50- Exploring Emotions through Music Making (Part Two: Preparing for Deployment)
00:50-1:00 -Discussion
1:00-1:15 – Open to Communication Mindfulness Exercise (p. 42)
1:15-1:30- Closing Discussion/Wrap-Up
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Guide Table 4
Music Therapy Interventions: Pre-Deployment
Description Goal/Objective Name of Intervention Exploring Emotions through This intervention incorporates • Connecting music with Music Making (Round 1) individual emotional emotional expression. expression, with family • Providing the opportunity cohesion and support. After to share part of their inner each person plays, family world members, then the entire • Increase listening and group will be asked to join communication skills and match and support what among family members. music portrays—discussion • Building community/group to follow. trust.
Exploring Emotions through Same as round one, except • Explore anticipatory Music Making (Round 2) the music now represents emotions, and address emotions experienced during difficult emotions (anger, pre-deployment. Same as sadness, grief, etc.). previously, a member will • Create an opportunity for a “solo,” then the facilitator family to strengthen bonds will ask the other family through listening and members and then the group understanding of one to join in supporting the another’s emotions. ”soloist.” Followed by • Create a feeling of discussion. community support and understanding “Open to Communication” A receptive music • Bring focus inward, focus Mindfulness Exercise experience, use recorded on breathing. (with repetitive, simple, • Increasing awareness of grounding melody), repetitive positive communication phrases that group members skills are encouraged to repeat, • Provide resources useful followed by quiet reflection outside of the session.
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Open to Communication Mantra
I open up my heart to receive
I open up my ears to receive
I open up my mind to receive (Repeat)
I am here for you
You are here for me
We are here for each other
(Repeat 2x)
I hear and understand you
You hear and understand me
We hear and understand each other
(Repeat 2x)
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Session Three:
Deployment: How to Stay Connected During Separation
Deployment is a topic that could span several sessions, or have a dedicated program focused on maintaining family and community connections throughout the separation. However, this guide will provide a single session that can expand or extend, based on the needs of the community the music therapist serves. The theme for this session is connection. Strengthening relationships and building new connections within the group “community.” Due to recent technology, there are more options to help families stay connected through deployment. Users can leave video messages for others to view and reply to when convenient with access to video messaging platforms such as Zoom, Skype, and FaceTime and apps like Marco Polo. Families can connect in ways in which past generations could not.
Improvisation and songwriting are two music therapy techniques used to form and strengthen connections within groups. In this session, participants will have opportunities to make music with the entire group, focusing on connecting with other group members.
The session allows group members to continue learning about songwriting and how to use it to connect as a family, even when the service member is away by taking advantage of technology. Songwriting takes time and can be a powerful tool. Songs can evolve and change over time, and multiple people can have input in song creation, and not all parties have to be in the same physical space to participate in the creative process. Songwriting can continue even when the service member is deployed and helps families stay connected through separation.
Therapeutic songwriting can be one of three models: insight-oriented, narrative, or psychoeducational (Baker, 2017). For this session, the songwriting intervention will introduce all three, and the group will begin the songwriting process together using the psychoeducational
47 model. Since music is known to connect people, discuss ways families have connected in the past.
Discussion Prompts and Questions
• What types of activities have you done with your family as a way to connect with one
another?
• What is it about these activities that help you connect?
• Has music ever been a part of these bonding activities?
• If yes, how has music played a role in connecting as a family?
• If not, after your experience today, could you see yourself using music to connect with your
family? In what ways?
Session Specific Resources Needed
Songwriting handouts (see Appendix D)
Sample Session Timeline
00:00-00:15 Welcome/Re-Cap
00:15- 00:30 How to Stay Connected Discussion
00:30-00:45 Improvisation and Process
00:45-1:15 Songwriting introduction and beginning process using Psychoeducational Protocol
01:15-01:30 Wrap Up/ Answer Questions Give instructions for “homework.”
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Guide Table 5
Music Therapy Interventions: Deployment
Name of Description Goal/Objective Intervention “Connection” Each participant will choose an instrument. As • Expressing emotions Improvisation participants begin to play therapist will give verbal • Listening to others prompts (ex. “match another person’s rhythm,” • Making eye contact “do not be afraid to look around the room, and with other group make eye contact with others,” etc.) This exercise members can be done multiple times with varying levels of • Reciprocating instruction or direction from the therapist. Discuss through mirroring how participants choose those they “connected” with in the music. What made the exercise easy/difficult? How did the level of outside support from the therapist affect the experience? Songwriting This intervention is the music therapy aspect of the • Naming emotions and “how to stay connected” discussion. Using the issues related to psychoeducational model of songwriting, the deployment theme of the song will be Connection Throughout • Collaborating with Deployment. Group will begin this process, and family members each family will take home sheets to continue the • Collaborating with process at home. Group members
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Session Four: Reintegration: New Connections, New Roles
Once the service member is home, the reintegration process begins. Reintegration is the period where families (re)learn how to live together and function as a singular unit again. The service member is transitioning from a mindset focused on military missions to their spouse and parent role. This experience can be quite jarring, especially for service members returning from deployments in dangerous locations such as combat zones. During deployment, the family had to adjust to the absence of one parent and spouse. Now that person has returned; however, reintegration does not mean everything goes back to how the family functioned before. Children and spouses may have new responsibilities, schedules, and routines. Children have grown and developed. The service member now has to discover their new role and fit in the family dynamic.
This process is not immediate, and it requires patience and open communication from all members of the family (DoD, 2012).
This session, like the deployment session, focuses on connection and communication.
Families OverComing Under Stress (FOCUS) is a resiliency program with both in-person and online resources. One of the top concerns from the service member’s perspective centers around the possibility of not being able to relate or feel like talking to family members because service members feel family members cannot understand. The spouse (or “waiting warrior”) perspective is noticing whether the service member appears distant and how the spouse can help them process the transition and be present (FOCUS, 2017b). This session's psychoeducational component engages participants in a discussion about past reintegration experiences, difficulties, lessons learned, and new roles family members played. Discussing issues as a group can allow family members to explore past experiences with others who share similar experiences and practice effective communication skills. Provide families with an Effective Communication
50 handout (Appendix E) for reference during exercise. Music therapy interventions include instrument playing, improvisation, and songwriting. After incorporating active listening skills into the music therapy interventions, compare this experience using communication skills with the last session's experience. Focus on the effects of incorporating these skills. Groups with young children or individuals with limited verbal abilities may require adaptations for discussions including but not limited to using drawings, augmentative and alternative communication devices, or semi-structured play, such as story-telling, puppets, or props (Lucas,
2019).
Discussion Prompts
• Were there differences between last week’s session and this experience? What were they?
• What is one thing you have learned that you can take away from this experience?
• How does incorporating these skills affect how you communicate with others?
o As the listener? As the speaker?
Session Specific Materials Needed
Effective Communication Handouts (see Appendix E)
Recording device with playback option
Sample Session Timeline
00:00-00:15 Welcome/Re-Cap/Improvisation
00:15- 00:25 Process Improvisation Experience
00:25-00:45 Effective Communication Handout and Reintegration Discussion
00:45-1:00 Communicating with Instruments
01:00-01:20 Songwriting – Reintegration verse
01:20-01:30 Final Discussion/Wrap-Up
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Guide Table 6
Music Therapy Interventions: Reintegration
Name of Description Goal/Objective Intervention Improvisation At the start of the session, have instruments in the center of the • Self-expression circle. After the welcome, inform group members they will be • Awareness of starting with an improvisation experience. Provide minimal self and others guidance, sit quietly until either group needs further • Active listening guidance/encouragement to begin or someone begins to play, the therapist may participate but not required to provide a “heartbeat” or steady rhythm.” Let the group guide this experience and note the communication skills (or lack thereof) that group members are using during this exercise. Try to let the experience end organically, intervening if deemed necessary. Communicating Option 1: “Telephone” Group stays together; everyone has the • Practice active with same type of instrument, the first person plays a musical phrase, listening Instruments starting with shorter phrases and getting longer as the group can • Listen to participate successfully. Subsequent participants play the same nonverbal cues beat or melody in the same way the previous player played it. (timbre, dynamic, body Option 2: “Family Chat” This option is best when it is feasible or language). desirable to have families split into smaller groups. Each family • Making eye member picks an instrument to represent themselves and their role contact within the family. Each member plays a short musical phrase • Acknowledging directly to another family member of their choice by making eye and respecting contact with that family member. The chosen family member will others' then playback the phrase. If played back correctly, indicated by a perspective head nod from the original player, that family member makes eye contact with another family member and continues experience.
Both options can expand into a conversation. The second player responds to the musical phrase instead of repeating the phrase. Eye contact is necessary for the next person to play and respond. Songwriting- Families can continue to write their songs from “ (see session 3). • Expressing “Connection Group will write a new verse that encompasses the experience of emotions through coming home from the whole family’s perspective. This can be • Exploring Deployment” done in family units or the group as a whole, consult group, and family strengths continued use clinical judgment to decide which works best in each situation. • Collaboration with family and group.
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Session Five
Relocation: Coping with Frequent Moves
Relocation is common in military families and is referred to as Permanent Change of
Station (PCS). When working with military families, this term is heard as frequently as deployment. PCSing is synonymous with moving. Many challenges go along with relocating: acclimating to a new area, making new friends, finding employment for spouses in the workforce, adjusting to new schools for children, and adjusting to a new command for the service member that may also come with new responsibilities and a different deployment cycle.
There are resources to help families prepare for upcoming moves; Appendix F is a non- exhaustive list of these resources, ranging from military spouse blogs to DoD-sponsored websites.
This session focuses on the emotional challenges families face through the process of relocation. While the actual moving experience is an important one, do not let the participants overrun the discussion with moving stories. Instead, explore challenges faced by all family members (i.e., leaving support systems, finding new ones, and how frequent moves affect building these relationships). Music interventions will help group members explore feelings related to moving and practice communicating these feelings with family members and group participants. The author’s goal for these sessions is to create a space to build a community that flourishes outside the group sessions.
Discussion Questions and Prompts
• What is your favorite thing about PCSing?
• What is the most challenging?
• How have you talked about PCSing in the past?
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• Do you always view every PCS the same? Why or why not?
• What is the first thing you do when you arrive at your new duty station?
• What is the last thing you do before you leave a duty station?
Session Specific Materials Needed
PCS Resource List (Appendix F)
Lyric Sheets for lyric analysis exercise
Highlighters
Sample Session Timeline
00:00-00:15 Welcome/Mindfulness & Improvisation
00:15- 00:25 Relocation discussion
00:25-00:50 Lyric Analysis
00:50-1:15 - Songwriting – relocation verse
01:15-01:30- Wrap-Up/Questions/Homework Assignment
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Guide Table 7
Music Therapy Interventions: Relocation
Name of Description Goal/Objective Intervention Mindfulness and After Welcome, have participants close their eyes • Self-awareness Improvisation and focus on their experiences relocating. Have group members take a few deep breathes, and you may choose to do this in silence or choose a short piece of music that is grounding, instrumental, and repetitive. Use judgment for how unstructured this experience can be (introducing a steady beat, leading the experience, or letting the experience happen organically within the group). If using music for the mindfulness experience, Instruct participants to choose instruments once the music is finished and begin to play when ready. Music Listening Choose from the list below or another familiar • Self-reflection and Lyric song. The theme is relocation/moving. Listen at • Learning how to Analysis* least 2x. First, have everyone close their eyes and use music to listen to the song. Pass out lyric sheets and pens, explore pencils, or highlighters. Have participants mark feelings/emotions lyrics that stood out to them, are meaningful or impactful. After the second time, allow a few minutes for participants to gather thoughts/write about their experience. Facilitate discussion: How did you relate (or not) to the song? What lyrics stood out to you? Song Writing Continue the Songwriting experience from the • Self-expression previous two sessions. Work with the group to • Collaboration with write another verse about moving/relocation. family and group Each family can also choose to write personalized lyrics if they choose. The focus for this program is a group song, as time is limited. Homework Have each family member pick a meaningful • Practice using Assignment- song, have them listen and do a lyric analysis on music as a coping Lyric Analysis their own, and be prepared to share that skill and Song Share experience at the next session. • Expressing emotion *Compile a list of songs and share with the group
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*Song Idea List
Good Riddance (Time of Your Life) (Green Day, 1997)
I’ll Always Remember You (Hannah Montana, 2010)
Life is a Highway (Rascal Flatts, 2006)
Move (Keep Walkin’)(TobyMac, 2015)
Moving (Travis, 2013)
See You Again (Khalifa & Puth, 2015)
Song for Leaving (Dennen, 2011)
Tattoos on This Town (Aldean, 2010)
*These songs were chosen based on the author’s knowledge of the challenges families face with frequent relocations. This is not an exhaustive list; instead, it provides a few examples of songs about moving and changes from different genres. The music therapist can also ask group members about songs that have helped them transition. This experience may need to be adapted to include songs with a concrete message for the group's children. The Hannah Montana song is an example of a more concrete song about leaving. The author was unable to find good song examples for very young children. This is an excellent opportunity for songwriting; the reader may consider writing a song about relocating for the pre-kindergarten and early elementary school age group.
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Session Six:
Bringing It All Together
This final session will look different for every group depending on their experiences and preferences in the previous five sessions. Some groups may want to further discuss their experiences verbally; some groups may want to process their overall experiences by engaging in active music-making. If the group did not finish writing the song from Week Three, completing it is an excellent way to bring the program to a close. After the session is complete, participants may want a recording of the song. Sending finished lyrics and a recording is a way for families to remember their experience.
Let the group lead the topic focus. If prompting is needed, start with an overview of what the group has learned and done throughout the program. Encourage involvement in the discussion by asking open-ended questions about their experiences.
Discussion Questions
• “What was the most meaningful experience you had during this program?”
• “Is there a topic you would like to revisit? If so, which one? What would you like to
explore further?”
• “What music intervention (session) did you find most meaningful, and why?”
• “What is something new you learned during this program?”
• “What is something that you have learned about your family during this program?”
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Session Specific Materials Needed
Computer
Projector (if possible)
Session Timeline
The timeline for this session will look different for each group. After the welcome, begin this session with the song share, have each person share the song they chose. Depending on the group's size, each person can share the song or a part of the most meaningful to them and share why they chose the song. If you have access to a projector, use it to project lyrics for all group members to see. If a projector is not available, ask for song titles before the group and provide participants copies of the song lyrics. After this, the session will be varied and based on experiences that help the group process the ending of your time together. Allow time for proper closing, include time to answer any questions, end with the group song or other music experience to bring the session to a close. After the session is over, have resources available to those who need them and make referrals as appropriate/needed.
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Guide References
Aldean, J. (2010). Tattoos on this town [Song]. On My Kinda Party. BBR Music Group.
Baker, F. A. (2017). A theoretical framework and group therapeutic songwriting protocol is
designed to address burden of care, coping, identity, and wellbeing in caregivers of
people living with dementia. Australian Journal of Music Therapy, 28,16-33.
Davis, J. M., Finke, E., & Hickerson, B. (2016). Service delivery experiences and intervention
needs of military families with children with ASD. Journal of Autism & Developmental
Disorders, 46, 1748-1761.
Dennen, B. (2011). Song for leaving [Song]. On Loverboy. Dualtone Records.
Dorvil, M. (2017). Survey of Active Duty Military Spouses (2017 ADSS). Office of People
Analytics. https://download.militaryonesource.mil/12038/MOS/Surveys/2017-Survey-of-
Active-Duty-Spouses-Overview-Briefing.pdf
FOCUS. (2017a). About us. https://focusproject.org/about
FOCUS. (2017b). Top questions: Service members. https://focusproject.org/top-questions-
service-members
Green Day. (1997). Good riddance (Time of your life) [Song]. On Nimrod. Reprise.
Hannah Montana. (2010). I’ll always remember you [Song]. On Hannah Montana Forever. Walt
Disney Records.
Khalifa, W., & Puth, C. (2014). See you again [Song]. On Furious 7: Original Motion Picture
Soundtrack. Atlantic.
King, E., Rossington, G., & Van Zant, R. (1974). Sweet home Alabama [Song]. On Second
Helping. MCA.
59
Lucas, F. (2019 Aug 27). How do children communicate through play, and why is it important?
The Sector. https://thesector.com.au/2019/08/27/how-do-children-communicate-through-
play-and-why-is-that-important/
Ohio State University Project Team. (2011, January 6). Education services for military
dependent children with autism: Phase 2: Final project report submitted to the
Department of Defense, Deputy Assistant Secretary of Defense, Military Community and
Family Policy. http://download.militaryonesource.mil/
12038/MOS/EFMP/DOD_ASD_Final_Report_PhaseII
Peterson, R., & Green, S. (2009). Families first: Keys to successful family functioning
communication. Virginia Cooperative Extension (350-092), Virginia State University.
Retrieved from https://vtechworks.lib.vt.edu/bitstream/handle/10919/48300/350-
092_pdf.pdf?sequence=1&isAllowed=y
Rascall Flatts. (2006). Life is a highway [Song]. On Me and My Gang. Lyric Street.
TobyMac. (2015). Move (Keep walking) [Song]. On This is Not a Test. Forefront; Capitol CMG;
Universal.
Travis. (2013). Moving [Song]. On Where You Stand. Red Telephone Box.
Vaudreuil, R., Biondo, J., & Bradt, J. (2020). Music therapy with active-duty service members:
Group protocol description and secondary analysis of protocol evaluations. Music
Therapy Perspectives, miaa006, https://doi.org/10.1093/mtp/miaa006
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Guide Appendix A: Supplies Checklist Form General Supplies Checklist Session Specific Checklist
Clipboards/writing surface Session One:
Pens One copy per family of Family Profile (Appendix B) Pencils Copies of Songwriting Fill-in-the-Blank Loose Leaf Paper or Notebooks Activity
Accompaniment instrument(s) Session Two: (guitar/piano/ukulele) One copy per family of “Create Your Own Speaker Pre-Deployment Plan” (Appendix C)
Device to play music Copies of sample pre-deployment checklists to use as a guide. Variety of rhythm instruments and drums Session Three:
Extension cord Songwriting handouts (see Appendix D)
Extra guitar strings Session Four:
______Effective Communication Handouts (see Appendix E) ______Recording device with playback option ______Session Five: ______PCS Resource List (Appendix F) ______Lyric Sheets for lyric analysis exercise
Highlighters
Session Six
Computer
Projector (if possible)
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Guide Appendix B: Family Profile – Initial Assessment
*This questionnaire is designed to be completed by the family as a unit. Parents may answer for children with input as needed. **If you prefer not to answer a particular question, please leave it blank.
Adults/Parents:
Participants’ Ages: ______
Years Married or Cohabitating (if not married): ______
Dual Military: Yes No
Branch, Rank, and Years of Service (list both for dual military):
______
Number of Deployments (list separately, if dual military): ______
End Date of Last Deployment (month/year) (list both for dual military) ______
Spouses/Veterans: Are you currently employed? If so, full-time, part-time, or per diem?
______
For the service member: Have you ever been diagnosed with PTSD or any other combat- related injury?
Yes No Prefer not to answer
If yes, diagnosis and date of Diagnosis: ______
Have you participated in family therapy of any kind? If yes, briefly describe the experience.
Yes No Prefer not to answer
______
Have you participated in programs geared toward family bonding?
Yes No Prefer Not to answer
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If yes, is there anything you like to share anything about those experiences? ______
Musical Preferences for both adults: Please list favorite genres, artists, songs: ______
Do either of you have any experience singing or playing an instrument? If yes, please list experience here: ______
Children:
Number of children living in the home: ______
Ages of children living in the home: ______
Are any family members qualified under the Exceptional Family Member Program (EMFP)? If so, are needs being met? ______
Child(ren)’s musical preference. (Please list favorite genres, artists, songs): ______
Child(ren)’s musical experience (i.e. lessons, choir, band, etc.) Please list instruments/voice and level of experience: ______
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Guide Appendix C: Create Your Own Pre-Deployment Plan
Fill out each section below with what needs to be accomplished before the service member must leave on deployment. Make these as specific to your family as this is something you can reference when the time comes to ensure everything is in order. Use the back sheet of this paper if needed.
Military Financial
______
______
______
______
______
Legal Family (Dependents)
______
______
______
______
______
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Guide Appendix D: Song-Writing Protocols
Adapted from Baker’s Songwriting Protocols for Caregivers, 2017
Insight-Oriented Narrative Psychoeducational
• explore feelings • uses story-telling • Educates group and behaviors to reconstruct on relavent topic • develop insight narrative (i.e. connection • reconcile • explores past, • Based on conflicting present and discussions on feelings future alternative ways of thinking and • Lyrics focus on • Lyrics focus on behaving reframing telling the story thinking and • In the telling and • Group feeling retelling collaboratively • Allows feelings experiences and constructs of physical and feelings can be strategies to deal emotional stress evaulated and with day to day to be expressed reframed stressors
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Guide Appendix E: Effective Family Communication Handout
Building Effective Family Communication Adapted from Peterson & Green (2009)
COMMUNICATE FREQUENTLY
• Find time for meaningful conversation o Turn off electronics o Eat meals together • Use informal or formal family meetings to discuss important issues affecting family o Military-related (i.e., deployments, homecomings, relocations) o School-related o Other family issues • Use bedtime with children as an opportunity to talk • What are some unique ways your family can make time to communicate?
COMMUNICATE CLEARLY AND DIRECTLY
• State issues plainly and directly • Statements made directly to the appropriate family member(s)
BE AN ACTIVE LISTENER
• Respect and acknowledge the speaker’s perspective • Pay attention to both verbal and non-verbal messages o Facial expressions o Body language o If verbal messages do not match non-verbal messages, try to determine how the person is truly feeling. • Seek clarification if you do not understand (i.e., “Did I understand you correctly when you said…?” or “What did you mean when you said…?”)
BE POSITIVE
• It is possible to discuss difficult/negative topics while keeping communication positive. • Focus on family strengths (What are some of your family’s strengths? • Focus on problem-solving o AVOID criticism o AVOID contempt o AVOID defensiveness
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Guide Appendix F: PCS Resource List
Information and Tips:
Military One Source https://www.militaryonesource.mil/moving-housing/moving/pcs
Military Spouse Website www.militaryspouse.com
Military.com https://www.military.com/pcs/pcs-checklists.html
Local Resources: (include contact info, website, and address) Family Readiness Centers Housing Centers EFMP office School Liaison Officer
Planning and Scheduling Your Move: https://move.mil/moving-guide
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Reflection
This project's inspiration came from my personal experience as a military spouse and professional experience as a music therapist. Knowing the roots of music therapy were in volunteer musicians working with wounded service members, it only made sense that music therapists continue to serve military families, using our unique skills to address goals in a new and unique way. I learned about the process of advocating for programming on military bases, the importance of networking within the armed forces network and about the resources currently available for military families. I know there is so much more for me to learn. I have made connections with several individuals in the military community that I hope to contact as I take possible next steps with this project.
Although I could not complete my study as initially envisioned, this project has morphed into something tangible from which I can build and expand, and hopefully, one day publish. The process took a lot longer than I originally planned. Doing a thesis during a global pandemic was an experience that I cannot fully put into words. There were many times I wanted to give up altogether. However, I had the privilege of being surrounded by a wonderful support system in my family, cohort, and thesis committee. I am thankful that I had supportive committee members. They understood when my timeline slowed down dramatically, gave me time and encouragement to refocus and plan my next steps, finally deciding on my program guide. As I waited for evaluative feedback, I was nervous to know what other music therapists who have had extensive professional experience with this population thought of my proposal. I understood the military culture from a personal perspective and wanted to use my clinical knowledge to create something beneficial for military families.
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After receiving feedback, it was clear that this topic is important and that I have focused in on an area of clinical need in our field. Family-centered music therapy within the military population is an area that requires more access in order to perform research and provide clinical support. Some obstacles still need to be overcome, but I have gained a significant amount of knowledge on the topic through this process. I have made meaningful connections with experts in music therapy with military populations, and individuals within the U.S. Armed Forces and
Creative Forces network. The feedback and guidance I received over the last year have been invaluable. The possibility of future collaborations with individuals who already have boots on the ground and can use this protocol is exciting.
There was conflicting feedback regarding the recruitment process and suggested participant makeup of the group. Several individuals stated they were not sure if recruiting only officers or only enlisted families was a prudent decision as it further promotes the military hierarchy. In contrast, others understood the need for this separation. I decided to promote the separation as initially suggested and look for feedback in this area, specifically when piloting the program and other music therapists as they recruit for their programs. One evaluator suggested to do it both ways and record the results. I am curious how the two scenarios will compare, and what the results will show regarding the hierarchical military system concerning families and community building.
If doing this project again I would reach out more for support; when I asked I was provided with just what I needed at that moment. Thesis writing can be a grueling undertaking and can often feel overwhelming. I wish I had been more open with my struggles, which may have allowed me to move quickly through those challenging times when I felt stuck. After running a feasibility test and piloting the program, I would love to publish this guide and make
69 adjustments as needed before publishing. When I eventually run this program, I want to collaborate with the base counselor to help process and connect families to an available resource.
The study would be qualitative, using a narrative inquiry to explore the participants' experience as the most valuable and learn from the experience. Before publishing the guide itself as a product, I will most likely have to make editing and layout changes to make it more visually pleasing, using graphics or photos, and making the product user friendly, rather than trying to adhere to APA guidelines. I considered creating a website with accessible tools, more resources, and published research using the protocol.
After speaking with Rebecca Vaudreuil, who currently works within Creative Forces, I realized that guides such as these go through many versions as the individuals use and provide feedback on the program. I would like to publish this guide in collaboration with the National
Endowment for the Arts Creative Forces, utilizing the program throughout their network. In so doing, I would quickly discover the program's strengths and areas of need to allow program revisions based on feedback from both participants and therapists from across the country. With the connections I have made throughout this process, I may make this a reality, which is an exciting possibility. I know we hear that “this is just your thesis” to manage expectations throughout this process. I am glad that I landed in a place where I can take this assignment and continue to grow it into something essential and valuable to the profession.
Conclusion
Music therapy has origins in working with the military population with programs like
NEA’s Creative Forces; creative arts therapies, like music therapy, are recognized as effective treatment modalities. The program proposed here introduces music therapy in a new way, focusing on the family unit in a community-based setting. Music can be the bridge to creating
70 resiliency for military families by making connections with military communities. Music therapists can provide military families opportunities to uniquely come together to create memories, strengthen family bonds, and build relationships within their community.
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